The good and bad news of HIV in Malaysia

Minister expresses leadership in calling for effective prevention strategies at Malaysia’s First National AIDS Conference

Malaysia's Minister of Health, Dato' Seri Dr. Chua Soi Lek launches the country's First National AIDS Conference on 1 December, in conjunction with World AIDS Day. Looking on is the Deputy Minister of Health, Datuk Dr. Abdul Latiff Ahmad.

By Indra Nadchatram

KUALA LUMPUR, 15 December 2007 – The country’s First National AIDS Conference brought good news and bad news. Malaysia’s Minister of Health Dato’ Seri Dr. Chua Soi Lek highlighted that new reported HIV infections had reduced annually in the last five years, from 6,978 cases in 2002 to 5,830 in 2006.

The good news of the day however was marred with an accompanying announcement that women and girls in the country are becoming more threatened by this incurable disease.

A similar story unfortunately is being played around the world. Globally, women and girls account for nearly half of all new infections, with numbers rising in almost every region. Their greatest risk comes from having unprotected sex (without a condom) with a male partner who is HIV positive.

When HIV first hit our shores in 1986, it was only diagnosed amongst men. It wasn’t till much later, in 1988 that a woman was reported HIV positive. Reported cases amongst women and girls remained below the hundreds until the mid-90s when it soared to 191 new cases in 1996.

Since then, HIV infections amongst women and girls have swelled four-fold with females making up for 15 percent of new cases in 2006 as compared to only 4 percent in 1996. This trend corresponds with the jump in heterosexual transmission of HIV from 5 percent in 1990 to 27 percent in 2006. Today, for every seven reported new cases in males, one is female.

Poor understanding of HIV

A concerned Dato’ Seri Dr. Chua cites poor understanding of HIV and its routes of transmission as one of the contributing factors to this new development in a country where HIV has been largely dominant amongst male injecting drug users.

“They don’t understand that anyone can get infected. They don’t understand that all it takes is a one time exposure to HIV to get infected,” he says. “We have a very democratic virus in our midst. It doesn’t discriminate against man or woman, rich or poor, married or single”.

The Minister’s concern for the situation should certainly raise alarm bells in all of us. For the intrinsic qualities women and girls bring to our society as mothers, sisters, caregivers; and for their roles as “creators of new life, the caretakers of daily life and the custodians and transmitters of community norms and social values”. When they die, their children lose love, care and support. Their loss is also our loss as the fabric of life is slowly ripped apart.

But how can we help our women and girls? In conservative Malaysia, we have faithfully promoted the As’ and Bs’ of the ABC method of prevention. Abstain and Be Faithful. Some argue that this should be enough in a land dictated by religious and cultural Asian norms. The rising numbers of HIV infections amongst women and girls on the other hand tell us it isn’t.

We teach that abstinence until marriage can help prevent HIV infections – yet we live in a world where abstinence is preached but not always practiced. We tell men and women to be faithful to their partners – but know that sometimes faithfulness in itself is not enough when a partner’s injecting drug use can also introduce HIV into a relationship.

Jeopardising the continuity of life

Dato’ Seri Dr. Chua believes that society cannot afford to turn its back anymore on the reality of Malaysia’s new AIDS story since women hold together the fabric of humanity – without them the continuity of life will be placed in jeopardy.

“An important aspect is that the individuals concerned must know their status of HIV infection, or that individuals be made aware they are at risk of getting infected with HIV”, he elaborates. “Women (and men) must be equipped with adequate knowledge and information on the risks of getting infected with HIV and on safer sex.”

The Minister’s call to action reveals a critical need to include the “C” – condom use – back into the ABC’s of HIV prevention.

It is certainly a bold call, and one which clearly demonstrates the Government’s leadership in wanting to effectively tackle the epidemic.

The Government however is cognizant that women sometimes simply don’t have the option to decide when and with whom they have sex; to negotiate condom use with their partners; and to live their lives free from violence.

Their appreciation of women’s limited options is clearly illustrated in the National Strategic Plan (NSP) on HIV and AIDS (2006-2010), which includes as one of six key priorities, the need for strategies to address women’s vulnerabilities to HIV.

Working together for solutions

But the Government’s commitment alone is not enough to help women and girls protect themselves against this wily virus. What is also clearly needed now to match the Government’s leadership is leadership from all other sectors of society.

Rather than expending time and effort to find fault, women and AIDS advocates should step forward to work in partnership with the Government to keep women and girls safe from HIV. Identifying flaws in proposed strategies is of no use if it is not accompanied with proposed solutions that are realistic and workable.

Considerable investment is being made to put in place frameworks and foundations, including an annual Government allocation of up to RM 4 million to civil society to engage them as partners in the national HIV response. We must move forward together as one force if we are to ensure that solutions for our women and girls are long term; and if we are serious of saving them and their future children from HIV.

Only together can we help increase women and girls access to information, to services and to resources that will teach them how to protect against HIV. Only together can we ensure they are equipped with skills and empowered with confidence to know how to say NO to behaviours that will place them at HIV’s door.

It doesn’t have to be bad news forever. Working in concert together, with mutual respect, we can change the course of AIDS in Malaysia.